2011 Flu Outlook: More Options, More Availability and More Americans Getting Vaccinated

The latest data on immunization rates and findings from a national consumer survey indicate positive trends in protection against influenza in the U.S. With more vaccine options than ever before and ample supply, the nation is poised to address remaining hurdles, according to public health and medical experts at the National Foundation for Infectious Diseases (NFID) news conference today.

Last season, an estimated 130.9 million people, or 43 percent of the U.S. population, received the influenza vaccine, representing a steady increase over the last several years. While some states, such as Maryland and South Carolina, which increased vaccine coverage last year by 6 percent and 7 percent respectively, made significant strides in immunizing residents, others have not. Children age 6 months to 17 years have seen the greatest increase in influenza vaccination
rates of all age groups. Signs of initial increases are also being seen in all adults age 18 to 49,
likely fueled, in part, by last seasons first ever inclusion of all healthy adults in the vaccination
recommendations.

Vaccination is the single most effective way to protect yourself, your family and your
community against influenza, says Thomas R. Frieden, MD, MPH, director of the Centers for Disease Control and Prevention (CDC). For most people, the flu makes them sick for a few
days but for others, especially children, the elderly and people with underlying health conditions,
it can be life threatening. I am getting vaccinated and I hope everyone over 6 months of age will
get vaccinated too.

According to Frieden, the country is well equipped to protect even more Americans from influenza this year, citing increases in vaccine supply, new vaccine options and a growing number of venues for the 2011-2012 season, as well as last years expansion of the vaccination recommendation to include all Americans older than 6 months of age. Additionally, a consumer
survey from NFID shows that healthcare professionals (HCPs) are increasingly recommending
influenza vaccination to their patients and patients are increasingly heeding this advice. The
proportion of adults who report this year that an HCP recommended the vaccine is up to 68
percent, a 10 percent increase from 2010 and 30 percent jump from 2008 levels.

William Schaffner, MD, president of NFID and chairman of the Department of Preventive Medicine at Vanderbilt University School of Medicine, led the conference, which in addition to Frieden, included some of the nations leading public health officials and medical experts from the CDC, Centers for Medicare and Medicaid Services, American Medical Association, American Academy of Pediatrics, American College of Obstetricians and Gynecologists, American Pharmacists Association, Indian Health Service, National Hispanic Medical Association, National Medical Association and National Influenza Vaccine Summit.

Ample Supply, New Vaccine Choices
More than 85 million doses of influenza vaccine are already available in doctors offices,
public health clinics, pharmacies and retail stores, among others; more doses will be available
throughout the season than ever before. Of particular note is that all 50 states now allow
pharmacists to administer influenza vaccine.

For the first time ever, four influenza vaccine options are available to meet the needs of
various populations: a nasal spray; the traditional intramuscular injected vaccine; a high-dose
injection for people age 65 and older; and a new intradermal vaccine that features a smaller
needle. There is a good influenza vaccine option for everyone, which means there is no reason
to go unprotected, says Schaffner. It is encouraging to see that we are making progress and
each year increasing the supply to accommodate expanding acceptance.

The CDC recommends a three-step approach to protect the American public against influenza.
Vaccination is the first step, but it should be coupled with everyday preventive actions such as
good hand and cough hygiene. For those who do get infected, appropriate use of influenza
antiviral drugs can greatly reduce the risk of serious complications from the infection. For the
2011-2012 season, CDC recommends either oseltamivir or zanamivir for treatment and
prevention of influenza.

Data Emerging on Impact of Influenza in Pregnant Women, Older Adults Still Most
Vaccinated Group
Influenza immunization rates are improving for pregnant women, but much more education is needed, according to Richard H. Beigi, MD, MSc, assistant professor of obstetrics, gynecology and reproductive sciences at the University of Pittsburgh and representative of the American College of Obstetricians and Gynecologists. The immunization rate for pregnant women was 49 percent during the 2010-2011 season, which is comparable to estimates for last season that range between 32 and 51 percent. However, influenza vaccination levels still remain below the public health goals of 80 percent for pregnant women. There is mounting evidence showing the benefit of influenza protection for pregnant women and their newborns during those first vulnerable six months before the baby itself can receive vaccine.

A recent CDC report that studied the impact of H1N1 influenza on pregnant women showed that those who became severely ill had approximately a 20 percent risk of dying, and that the risk of pre-term and low-birth weight infants was increased among those who delivered during their hospitalization. The positive news is that pregnant women who were treated with antiviral drugs early after symptom onset had a much better chance of survival.

The American College of Obstetricians and Gynecologists recommends influenza vaccination for pregnant women as a safe and an essential part of good pre-natal care, says Beigi. Instilling the value of annual influenza vaccination not only helps to protect pregnant women and their unborn babies, but it also helps to lay the foundation for making this healthy behavior a life-long habit for the entire family each and every year.

Because of a long-standing recommendation, the age group most likely to receive influenza vaccine is people age 65 and older; this age group achieved a 67 percent vaccination rate last year compared to 41 percent for all adults. We at the Centers for Medicare and Medicaid Services want every Medicare and Medicaid beneficiary to be protected from influenza and pneumococcal disease, says Shari M. Ling, MD, acting chief medical officer at the Centers for Medicare and Medicaid Services. CMS recognizes that influenza vaccination can prevent hospitalization and save lives, and is therefore sustaining a coordinated approach across healthcare settings to support and encourage appropriate vaccination of Medicare and Medicaid beneficiaries.

At the news conference, Schaffner urged people age 65 and older and those younger than 65 who smoke, have asthma or other risk factors like heart disease or diabetes, to also get their pneumococcal vaccine. Although it can occur any time of year, pneumococcal infection is a common complication of influenza. This makes it critical that at-risk individuals are protected
against both diseases as the influenza season approaches. Unlike the influenza vaccine,
pneumococcal vaccine is needed just one-time for most adults.

Public Perceptions: Progress and Remaining Hurdles
Influenzas seasonal toll is unpredictable, causing more than 200,000 hospitalizations and between 3,000 and 49,000 deaths in a typical year. Yet, lack of awareness about the need for
annual vaccination prevails along with some remaining misperceptions, representing an ongoing
educational challenge. According to an NFID consumer survey, nearly two-thirds (63 percent) of
adults report that they intend to get vaccinated this year.

Of the minority of people (36 percent) who do not intend to be vaccinated against influenza this season, more than two-thirds (69 percent) could be motivated to change their minds. Leading motivating factors include: the belief they might infect others who could become seriously ill (54 percent); a family members or friends influenza experience (37 percent); a recommendation from a healthcare provider (34 percent); reassurance of vaccine safety (31 percent); and a recommendation from an employer (21 percent). The majority of these factors were particularly meaningful among those age 18 to 34 years old.

Leading by Example: a Commitment to Influenza Prevention
To motivate more people to get vaccinated this season, NFID is calling on community leaders in healthcare, business, education and policy to lead by example and make a commitment to influenza prevention as a health priority in protecting their communities and the nation at large. Leading by example, Frieden received his influenza vaccination during the news conference, and NFID partners have also pledged their support. For more information on NFIDs new influenza prevention initiative, go to: www.nfid.org/influenza/leadingbyexample.